Entity Details

Basic

Entity Type:
Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)

Former Entity Name:
Faith Hope And Charity

Medicaid #:
0880674

CCN #:
16G055

Occupancy Type:
Beds

Max Occupancy:
32

Status:
Closed

Close Date:
02/29/2024

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
110439

Initial License Date:
10/10/1991

Current License Date:
02/01/2023

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
02/01/2024

Months Since Last Survey:
2

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1815 West Milwaukee

City:
Storm Lake

State:
Iowa

Zip:
50588-0243

Phone:
(712) 732-5127

Fax:
(712) 732-6002

URL:

Administrator/License #:
Bev Miller /

Administrator Email:
bmiller@hopehaven.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: